lngreen1107
New
We see tons of patients for Alabama Medicaid and I have a question regarding follow-up visits and EPSDT diagnoses.
Scenario: Patient is seen in February for EPSDT screening and H65.03 Acute Serous Otitis Media, bilateral is listed as a chronic diagnosis. Fast forward to March where patient is being seen for follow-up for ear infection. Tympanic membranes are normal. No note of discharge or any abnormalities upon exam. Provider lists diagnoses as Z09 and H65.03.
Now, since there is no documentation of current abnormalities and provider even says "BOM resolved" under her A&P, I would not include H65.03 as a diagnosis correct? I believe this should be Z09, Z86.69. This does not leave me with any EPSDT diagnoses to use and therefore uses up a visit for the patient.
I have read somewhere on a Medicaid forum that even if the EPSDT diagnosis is mentioned but not necessarily diagnosed for the visit that we can mark that as an EPSDT dx visit, but I'm not necessarily comfortable with that. Can someone please guide me on this?
I want to make sure that I am billing this correctly as well as doing what I can to help my patients and educate my providers when needed.
Thank you in advance for your assistance!
Scenario: Patient is seen in February for EPSDT screening and H65.03 Acute Serous Otitis Media, bilateral is listed as a chronic diagnosis. Fast forward to March where patient is being seen for follow-up for ear infection. Tympanic membranes are normal. No note of discharge or any abnormalities upon exam. Provider lists diagnoses as Z09 and H65.03.
Now, since there is no documentation of current abnormalities and provider even says "BOM resolved" under her A&P, I would not include H65.03 as a diagnosis correct? I believe this should be Z09, Z86.69. This does not leave me with any EPSDT diagnoses to use and therefore uses up a visit for the patient.
I have read somewhere on a Medicaid forum that even if the EPSDT diagnosis is mentioned but not necessarily diagnosed for the visit that we can mark that as an EPSDT dx visit, but I'm not necessarily comfortable with that. Can someone please guide me on this?
I want to make sure that I am billing this correctly as well as doing what I can to help my patients and educate my providers when needed.
Thank you in advance for your assistance!